The present literature review is devoted to the analysis of the features of the pathogenesis of atrial fibrillation in patients with arterial hypertension and to the optimal treatment tactics in this cohort of patients. In particular, pathological mechanisms (hemodynamic, structural, and electrophysiological) of the development of atrial fibrillation in arterial hypertension are reviewed. The article highlights the problems of primary and secondary prevention of atrial fibrillation using antihypertensive therapy as well as the aspects of the prevention of thromboembolic complications in patients with atrial fibrillation and arterial hypertension.

In the 21st century, hypertension remains a major health threat to the adult population worldwide, despite the phenomenal progress in the development of antihypertensive pharmacotherapy. Currently, the rate of pharmacological control of hypertension barely exceeds 50%. Indeed, pharmacotherapy is fundamentally limited by pharmacological/pharmacokinetic tolerance (adaptation) to the drugs as well as by non-compliance of patients with treatment regimens due to depletion of their psychophysiological function of self-control. Renal denervation (RDN) is a new non-drug treatment of hypertension. Renal denervation consists of a mini-electrosurgery on the renal sympathetic system where a catheter ablation is used to create a permanent block of conduction through the renal nerves. This procedure, in accordance with the function of the renal adrenergic receptors, increases glomerular filtration, reduces tubular water reabsorption, and inhibits glomerular secretion of renin. After the over-disputed failure of the early version of RDN using the first-generation single-electrode catheter system in the SYMPLICITY HTN-3 study, therapy was virtually reinvented with a new three-dimensional multi-electrode design and an anatomically optimized procedure. The new device design ensures deployment of the electrodes in a pre-defined fully circumferential pattern. Moreover, this design provides a radial contact that presses the electrodes against the arterial wall thereby maximizing the efficiency of radiofrequency (RF) tissue heating. Another major improvement of RDN therapy is the anatomical optimization of the procedure by extending the treatment into the segmental branches of the renal artery where the renal nerves concentrate the most around renal vessels. This article presents an analysis of the current state-of-the-development and future perspectives of RDN therapy.

Arterial hypertension and type 2 diabetes mellitus are the most widespread comorbid pathologies. The coexistence of these disorders accelerates the development of micro- and macrovascular complications, considerably increases the cardiovascular risk, as well as the risk of stroke and end stage renal disease. The synergism of these two pathologies is caused by the unity of pathogenetic mechanisms. Genetic predisposition also contributes to the development of both pathologies. It is well known that blockade of the renin-angiotensin system slows down the development of type 2 diabetes mellitus and also reduces the frequency of cardiovascular or kidney events in patients with these disorders. Gene polymorphisms of the reninangiotensin system are thoughtfully studied in the context of cardiovascular disease development. Currently, the role of gene polymorphisms in the development of carbohydrate disorders is not established, however, there is a high probability of their influence and importance. The purpose of review is to analyze the accumulated data on the effects of the renin-angiotensin system gene polymorphisms on the development of arterial hypertension and type 2 diabetes mellitus.

The authors’ report presents a brief review of the key studies, providing the reason for the use of vascular endothelial growth factor as a marker for stratification of the risk of cardiovascular complications in patients with essential hypertension.

In recent years, the comorbid course of cardiovascular diseases, primarily arterial hypertension with impaired carbohydrate tolerance or type 2 diabetes mellitus, is becoming increasingly important in the developed countries of the world. In this regard, the need for a more detailed study of the general mechanisms of the development of arterial hypertension, pre-diabetes, and type 2 diabetes mellitus, namely inflammation, is increasing. There are many studies that investigate the role of inflammation in hypertension and associated glucometabolic disorders, but the exact mechanisms by which activated immune cells lead to the development and maintenance of these conditions remain to be seen. Obtaining new data in this area may contribute to a deeper understanding of cardiometabolic disorder pathogenesis. It may allow to predict the progression of these disorders at the early stages and to develop effective preventive and therapeutic tactics for their correction.

Patients with resistant arterial hypertension have a high prevalence of cardiac pathology. In particular, left ventricular hypertrophy and reduced coronary reserve play independent role in determining the risk of cardiovascular complications. Diagnostic approaches to their detection are currently represented by a wide range of highly informative studies using modern ultrasound equipment, magnetic resonance imaging, computed tomography scanner, and gamma camera. The active study of the involvement of the cascade of pathophysiological mechanisms in the development of cardiac changes in hypertension allows not only to identify the factors associated with the severity of the lesion, but also to find new application points for the cardioprotection and to reduce cardiovascular risk. Along with the pharmacological capabilities, the renal denervation method is currently under active study. Despite high variability of the results and their poor predictability, a number of studies show the efficiency of this method in correcting the structural and functional changes in the heart, which is of important prognostic value for resistant hypertension.

Hypertension is of interest for many Siberian researchers. Given the climatic, geographical, socio-economic, and ethnic characteristics of the population living in Siberia, addressing this problem has been one of the main goals of large epidemiological studies for several decades. This article discusses the main results of the epidemiological studies conducted in the Siberian Federal District on the prevalence of hypertension and its risk factors.

Calcific aortic stenosis is the most common valvular heart disease. The pathogenesis of this disease is complex and resembles the atherosclerotic process in the blood vessels. It is known that valvular interstitial cell activation and subsequent differentiation into osteoblast- and myofibroblast-like cells is the main driving force of fibrous and calcified aortic valve tissue. However, the molecular mechanisms behind these processes are still not fully understood. Current information on this issue is collected and analyzed in this article. The main molecular pathways mediating the pathological differentiation of the valvular interstitial cells and the reasons for their activation are considered.

Introduction. The importance of studying treatment in older hypertensive patients is underlined by the tendency to aging of the population as a whole. During recent years, the approach to therapy of older patients changed. The guidelines on management of arterial hypertension recommend lower target blood pressure values and earlier start of the treatment.

Aim. To study the quality of arterial hypertension treatment and clinical characteristics in older patients (≥65 years).

Material and Methods. The Russian national registry of hypertension was conducted in 22 regions of the Russian Federation since 2012. It included 53 city primary health care centers and five cardiology clinics. The data were analyzed in two groups comprised of 65 to 79-year-old individuals and patients older than 80 years. Data on physical, instrumental, and laboratory examinations, as well as data regarding antihypertensive and lipid-lowering therapy and comorbidities, were analyzed.

Results: Patients aged 65 to 79 years and those older than 80 years had coronary artery disease (42.7% and 55.5%), chronic heart failure (CHF) (46.8% and 55.7%), history of Q-wave myocardial infarction (MI) (6.4% and 5.9%), stroke (5.5% and 5.7%), atrial fibrillation/flutter (3.7% and 6.5%), chronic kidney disease (CKD) stage 3–5 (36.6% and 48.4%), and diabetes mellitus (19.4% and 13.4%). Following the guidelines on management of arterial hypertension 2013, the target values of systolic blood pressure were achieved in 30% of patients; target values of diastolic blood pressure were reached in 60% of patients. Decreases in systolic blood pressure lower than <120 mmHg and in diastolic blood pressure lower than 70 mmHg were found in 3% of patients. In accordance with Guidelines 2018, target values of systolic blood pressure were achieved in 21–24% of patients; target values of diastolic blood pressure were achieved in 12–13% patients. Ambulatory 24-h blood pressure monitoring was performed only in 2.8% of 65–79-year-old patients and in 1.9% of patients older than 80 years. Data on antihypertensive therapy were absent in 13% of medical records of patients who had indications for it. Medical records of 20% of patients with history of Q-wave MI, CHF, diabetes mellitus, and CKD did not contain data on administration of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Administration of beta-blockers and mineralocorticoid receptor antagonists in patients with hypertension and chronic heart failure was insufficient. Achievement of target cholesterol levels was insufficient in both age groups. 

Objective. To determine the impact of the I/D polymorphism of the angiotensin-converting enzyme (ACE) gene on the development of essential hypertension, taking into account gender differences.

Material and Methods. Clinical data were assessed and a molecular genetic study was performed in 602 people including 401 patients with essential hypertension and 201 individuals of the control group, representing the Belarusian ethnic group. Genotyping was performed using the method of polymerase chain reaction and restriction fragment length polymorphism.

Results. The distribution of genotypes of the I/D polymorphism of the ACE gene did not differ between patients with hypertension and normotensive individuals: II, ID, and DD genotypes were detected in 100 (24.9%), 192 (47.9%), and 109 (27.2%) patients and in 52 (25.9%), 108 (53.7%), and 41 (20.4%) people of the comparison group, respectively. Differences were found between the distribution of DD genotype in men with hypertension and in the control group, where the frequencies were 28.4% and 17.3% (p  =  0.04), respectively, in contrast to no differences in women: 25.8% and 23.3% (p  =  0.64), respectively. Carrying the DD genotype in men compared with the ID and DD genotypes (recessive model) of the I/D polymorphism of the ACE gene increased the probability of developing essential hypertension by 1.9 times (OR   =   1.89; 95% CI  =  1.04-3.44). The analysis of the prevalence of risk factors depending on the I/D polymorphism of the ACE gene showed that male patients with the DD genotype more often had burdened heredity in regard to the development of premature cardiovascular diseases (23 patients (37.7%)) compared with the individuals with II and ID genotypes: 13 (21.7%) and 14 (14.9%) patients, respectively (χ2  =  1.16; p  =   0.005), and mainly through the paternal line.

Conclusions. Development of essential hypertension is associated with the carriership of the mutant DD genotype of I/D polymorphism of the ACE gene in men. 

Aim. To determine and compare the levels of systemic inflammation markers (C-reactive protein (CRP) and cytokines) in different age groups of hypertensive patients with coronary artery disease (CAD).

Material and Methods. The study involved 106 patients (men) with hypertension and stable angina. Group 1 included 59 young and middle-aged individuals (52 [46.5; 55] years); group 2 comprised 47 elderly individuals (64 [62; 67] years; p < 0.001). The exclusion criteria were female gender, diabetes, myocardial infarction in the previous six months, exacerbation phase of chronic diseases, acute infectious and mental illnesses. The CRP levels were determined by ELISA test system (Biomerica, USA). The serum cytokine levels were assessed using Vector Best test systems (Russia). Statistical processing of data was performed in the freely distributed Rstudio software. The differences were considered statistically significant if p < 0.05.

Results. The levels of CRP and the frequencies of its increase did not significantly differ in patients with hypertension and CAD in different age groups and were within the reference values, which was, probably, due to the use of drugs with systemic antiinflammatory effect. Increases in the IL-6 levels were more common in group of young and middle-aged men (47, 85.5%/27, 62.8%, p = 0.032). Increases in the IL-8 levels were also more frequently detected in young and middle-aged patients (10.7 [7.3; 19]/5.9 [4.35; 9.3], p = 0.006).

Conclusion. Obtained data suggest both an increased risk of acute cardiovascular events and more aggressive course of CAD in young and middle-aged patients with hypertension, and a possible onset of early vascular aging in this group. 

Background. Despite overall efforts, arterial hypertension remains one of the most significant medical and social problems. The risk of developing arterial hypertension is tripled in obese individuals compared with people who have normal body weight. According to clinical studies, individual biochemical markers can be predictors of initiation of remodeling processes in systems at a preclinical level. Endothelial dysfunction is the initial stage in the development of atherosclerosis. Mechanisms of the vascular inflammatory response in arterial hypertension with obesity can be considered a factor that largely determines the onset and course of the disease, a cause of its aggravation, development, and progression. Cardiovascular risk factors, genetic predisposition, deficit of sex hormones, and aging affect the endothelium function.

Aim. To study specifics of hypertension in postmenopausal women with abdominal obesity and to evaluate the role of inflammatory response markers, leptin, and female sex hormones in the pathogenesis of vascular wall stiffness.

Material and Methods. The study included 164 patients divided into three groups. Group 1 consisted of 42 healthy women aged 44.43 ± 14.26 years; group 2 comprised 62 hypertensive women aged 60.69 ± 7.09 years; group 3 comprised 60 hypertensive women with abdominal obesity aged 57.24 ± 7.40 years. Patients of all groups received 24-hour blood pressure monitoring, sphygmography, and assessment of sex hormones, lipids, inflammatory, and biochemical parameters in blood serum.

Results. Results of analysis showed that patients of group 3 had significantly higher blood pressure compared with that in group 2. Higher pulse wave velocity was observed in women of group 2. Groups 2 and 3 had lower levels of sex hormones and significant increases in the levels of inflammatory markers compared with those in control group. Multiple multidirectional correlations between the studied parameters were revealed.

Conclusions. Features of hypertension in postmenopausal women with obesity consist in a systolic-diastolic variant of hypertension, an increase in systolic blood pressure variability at night, an increase in diastolic blood pressure during the daytime, and increases in systolic and diastolic blood pressure at night. The method of logistic regression allowed to identify biochemical markers that determine the elastic properties of the vascular wall in this category of patients, namely: leptin, highsensitivity C-reactive protein, and endothelin-1. 

Aim. To study the peculiarities of changes in the functional state of the kidneys and heart muscle in patients with arterial hypertension.

Materials and Methods. A total of 88 patients with arterial hypertension were included in the study. Chronic kidney disease was detected based on glomerular filtration rate, albuminuria, and cystatin levels in serum and urine. The stage of chronic heart failure was determined according to Strazhesko–Vasilenko classification with functional class according to NYHA; functional class of chronic heart failure was determined based on six-minute walking test. Patient inclusion criteria were the presence of essential hypertension of degree 1–3 and the age from 50 to 70 years. Patients underwent anthropometry, biochemical blood tests, six-minute walking test, and standard echocardiography.

Results. Arterial hypertension of degree 1–2 was diagnosed in 50 patients including 33 women and 17 men. Grade 3 arterial hypertension was found in 38 patients (28 women and 10 men). Patients were divided into two groups according to gender. The groups with arterial hypertension degree 1–2 differed in their blood pressure levels. Echocardiography data showed the formation of heart failure with preserved ejection fraction. The groups differed in the values of left ventricular ejection fraction and end-systolic and end-diastolic sizes of the left ventricle. The levels of cystatin C in serum were elevated in both groups. The serum and urine creatinine levels and glomerular filtration rates differed between groups. Women had more significant decreases in the values of glomerular filtration rate, cystatin C, and urine creatinine. Correlation relationships were found between systolic blood pressure and glomerular filtration rate (r = 0.27, p < 0.05) and between systolic blood pressure and left ventricular back wall thickness (r = 0.41, p < 0.05). Inverse relationship was found between left ventricular ejection fraction and albuminuria (r = –0.31, p < 0.05). Cystatin C level had inverse relationship with glomerular filtration rate (r = –0.47, p < 0.05) and direct relationship with left ventricular myocardial mass index (r =  0.24, p  <  0.05).

Discussion. Chronic kidney disease and chronic heart failure with preserved left ventricular ejection fraction were detected in patients at early stages. In the group of women, more pronounced changes in the renal and cardiac functions were found. Cystatin C is a marker of kidney function reduction and an alternative marker of chronic heart failure. The study showed that the level of cystatin C in blood serum of patients was increased, which correlated with the functional activities of the kidneys and the heart.

Conclusion. In case of arterial hypertension in the presence of chronic kidney disease, the development of the left ventricular hypertrophy and heart failure with preserved ejection fraction was found. Women had more significant changes in the renal and cardiac functions compared with those in men. 

Aim. To investigate the effect of indapamide and bisoprolol monotherapy on cerebrovascular reactivity (CVR) in patients with combined hypertension (HT) and rheumatoid arthritis (RA).

Materials and Methods. A total of 66 patients with HT grade 1-2 and RA (average age of 59.0 ± 7.5 years) were included in an open-controlled randomized study in parallel groups. Group 1 included 33 patients treated with indapamide 2.5 mg/day. Group 2 included 33 patients treated with bisoprolol 6.0 ± 2.6 mg/day. We performed 24-h blood pressure monitoring and transcranial Doppler ultrasound of the middle cerebral arteries (MCA) with assessment of CVR during hyperoxia and hypercapnia tests before and after 24 weeks of treatment.

Results. Indapamide treatment improved CVR parameters during hypercapnia test. The MCA peak systolic velocity increased significantly from 53.7 [34.8; 67.8] to 55.8 [37.6; 69.0] сm/s (p = 0.017). Bisoprolol treatment worsened CVR parameters during hypercapnia test. The speed modification of MCA blood flow velocity decreased significantly from 0.10 [0.05; 0.19] to 0.08 [-0.01; 017] cm/s2 (p = 0.032). The index of recovery of MCA blood flow velocity decreased significantly from 1.11 [0.95; 1.27] to 0.84 [0.78; 1.08] (p = 0.006)

Conclusion. Indapamide treatment improved CVR parameters, but bisoprolol treatment worsened CVR parameters during hypercapnia test in patients with combined HT and RA. 

Aim. To analyze the dynamics of echocardiographic parameters after surgical treatment of severe pulmonary hypertension in patients with mitral valve disease and atrial fibrillation.

Material and Methods. Data of surgical treatment in 202 patients with mitral valve disease complicated by severe pulmonary hypertension with blood pressure more than 40 mm Hg and atrial fibrillation were analyzed. Surgical intervention in these patients consisted in surgical correction of mitral dysfunction with artificial prosthetic valve or valve-preserving intervention (group 1, n = 62). In patients of group 2 (n = 89), correction of mitral valve defect was also performed as well as the Maze IV procedure for concomitant atrial fibrillation using bipolar radiofrequency ablator AtriCure. Patients of group 3 (n = 51) underwent integrated surgery, which consisted in the elimination of mitral valve defect, surgical correction of atrial fibrillation by Maze IV procedure, as well as circular radiofrequency denervation of the trunk and mouth of the pulmonary arteries (pulmonary artery denervation (PADN)).

Conclusions. The circular PADN procedure was effective and safe, significantly reduced the level of pulmonary hypertension in the postoperative period (p = 0.018), and promoted reverse remodeling of the heart cavities. Integrated surgical correction in patients with mitral dysfunction, atrial fibrillation, and severe pulmonary hypertension may significantly reduce the phenomenon of heart failure (p = 0.023). Further analysis of the effectiveness of radiofrequency denervation of pulmonary arteries with the study of a larger number of patients, analysis of long-term results, as well as determining the possibility of this technique in patients with non-valvular forms of pulmonary hypertension are required. 

Justification. The results of endovascular revascularization are largely determined by the type of stents used. The use of baremetal coronary stents significantly worsens the long-term results of endovascular treatment of coronary artery disease. Given the widespread use of bare-metal coronary stents in the Russian Federation for the treatment of coronary artery disease and acute coronary syndrome, in particular, the issue of the impact of the above-mentioned endovascular interventions on the long-term results of coronary artery bypass grafting (CABG) performed after endovascular revascularization of the clinically related artery in patients with acute coronary syndrome and multivessel lesions does not lose relevance.

Aim. To compare the long-term results of the staged strategies of revascularization of the coronary bed: CABG performed after stenting the clinically related artery with third-generation biodegradable polymer-based sirolimus-eluting stents for acute coronary syndrome and CABG performed after stenting the clinically related artery with bare-metal coronary stents for acute coronary syndrome.

Material and Methods. The analysis used the data of two-year follow-up of patients who underwent two-stage revascularization: at the first stage, patients received stenting of the clinically related artery for acute coronary syndrome and, at the second stage, they received coronary artery bypass grafting no later than 90 days from the date of stenting. The study included 218 patients with multivessel lesions of the coronary bed, admitted with clinical manifestation of acute coronary syndrome. The long-term follow-up period was 24 months. The following end points were analyzed: cardiovascular mortality, myocardial infarction, re-revascularization, and combined MACCE end point (cardiovascular mortality, myocardial infarction, acute cerebrovascular accident, and re-revascularization). The observation was carried out at the hospital stage and, then, on an outpatient basis once every three months.

Results. There were no significant differences between the groups. The frequency of repeated revascularization, including repeated revascularization of the stented artery, and recurrence of angina were significantly higher in the group with baremetal coronary stents. There were no significant differences between the groups in regard to cardiovascular mortality, nonfatal myocardial infarction and acute cerebrovascular accidents. The frequency of MACCE events was significantly higher in the group of bare-metal coronary stents, mainly due to the frequency of repeated revascularizations.

Conclusion. Coronary artery bypass grafting performed in the early period after stenting of the clinically related artery using bare-metal coronary stents in patients with acute coronary syndrome and multivessel lesions was associated with a significantly larger number of repeated coronary revascularizations and higher rate of recurrent angina compared to a similar strategy, but with the use of modern third-generation biodegradable polymer-based sirolimus-eluting stents.

Background. Every year the number of operations of transcatheter aortic valve implantation increases, and the number of centers performing this intervention increases too. In this article we present the results of the operation of transcatheter aortic valve implantation at the Clinic of Advanced Medical Technologies named after Nikolay I. Pirogov St. Petersburg State University.

Material and Methods. From December 2015 to December 2018, the specialists of the Clinic implanted 46 self-expanding transcatheter aortic valves of 2 generations – CoreValve and CoreValve Evolute R. All patients were patients of high and extremely high surgical risk for severe aortic stenosis. The decision on the implementation of TAVI was taken collectively as part of the “Heart Team”.

Results. Most operations were performed under general anesthesia with transfemoral access (89%). In 2 cases (4.3%) the conversion of transcatheter surgery into an open cardiac surgery was required due to the development of intraoperative complications. Hospital mortality was 6.5%, non-fatal complications were 21.7%. Now we have mid-term results of CoreValve valves implantation. The functional class of heart failure is estimated to be no higher than II (by NYHA), the observation period is from 6 months to 2.5 years, and the hemodynamic parameters of the valve are satisfactory. Medterm results from the use of CoreValve Evolute R are expected.

Conclusion. The TAVI procedure in patients of high and extremely high surgical risk is an alternative to open operation, showing not-worse (non-inferiority) early and medium-term results. Treatment of patients with intraoperative aortic insufficiency of the 2nd degree requires further improvement. Further research is planned with a view to obtaining long-term TAVI results. 

Obstructive jaundice (OJ) is a syndrome characterized by bile staining of the skin, mucous membranes, and sclera as a complication of pathological processes that lead to disruption of the bile ducts at various levels of the biliary tract. Obstructive jaundice represents various diseases with different onset, course, and outcome, as well as etiology, which implies the difficulties of the diagnostic process. Identification of a cholestasis cause and treatment of patients with OJ remain urgent and difficult tasks due to the steady rise in diseases of the hepatopancreatoduodenal zone (HPDZ) and the high frequency of diagnostic errors. The latter can lead to the progression of liver failure, as well as to the development of severe complications, which, in turn, are fatal. A significant role in detecting HPDZ pathology belongs to the radiological methods of studies, such as transabdominal ultrasonography (TUS), endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC), endoscopic ultrasound (EUS), intraductal ultrasonography (IDUS), magnetic resonance cholangiopancreatography (MRCP), helical computed tomography (hCT), and helical CT cholangiography (hCT-CG). However, it should be noted that, as of today, there is no well-established conventional radiological algorithm for determining the causes of biliary obstruction. This, in turn, leads to repeated or sequential inefficient administration of all possible methods of visualization, complicating the diagnostic algorithm. In this regard, it is advisable to perform an in-depth study of the Russian and foreign literature sources, highlighting the problem of an early and highly effective diagnostics of the causes of biliary obstruction in patients with OJ.

Kyphoscoliosis is a combined spinal deformation, which leads to a decrease in the volume of ‘working’ lung tissue with the development of alveolar hypoventilation and hypoxic vasoconstriction of the pulmonary arteries. These changes in a small percentage of cases lead to increases in pulmonary artery pressure and pulmonary vascular resistance. The pathogenesis of pulmonary hypertension in kyphoscoliosis shows resemblance to pulmonary hypertension in the setting of obstructive sleep apnea or hypoventilation in the presence of obesity. Patients with already present pulmonary hypertension may theoretically be candidates for standard pathogenetic therapy, but there is currently no evidence of the effectiveness of this treatment.

Aim. To evaluate the heart rate in the state of rest and to find its interrelations with gender, age, blood pressure level, estimated glomerular filtration rate, and metabolic syndrome components in the representative sample of Krasnoyarsk Krai population.

Material and Methods. Within the framework of ESSE-RF study, the representative sample consisted of 1 411 Krasnoyarsk Krai inhabitants aged 25–64 with no history of beta-blocker intake. With IBM SPSS v. 22, we calculated the descriptive statistics and checked group disparities for statistical significance (significant at p≤0.05).

Results. The median heart rate in the sample was 72 (66; 78) beats per minute. We found no significant disparities neither in gender (p = 0.182) nor in age groups (p = 0.084). The heart rate in hypertensive people (73 (68; 80) beats per minute) was significantly higher (p < 0.001) compared to those with normal blood pressure (71 (65; 76) beats per minute). Besides, the heart rate over 80 beats per minute was more prevalent in hypertension and prehypertension compared to normal blood pressure. Renal dysfunction was associated with a slight heart rate decrement, while hyperglycemia (blood glucose over 7 mmol/L), hyperuricemia, and obesity (both general and abdominal) were associated with increased heart rate. Dyslipidemia had no association with heart rate.

Conclusion. In Krasnoyarsk Krai population, the heart rate significantly increased in people with hypertension, prehypertension, or at least one component of metabolic syndrome (hyperglycemia, obesity, or hyperuricemia). In patients with prehypertension and hypertension, the heart rate over 80 beats per minute was significantly more prevalent compared to people with normal blood pressure.